beep t-shirt order form

1
Beep T-Shirt Order Form Farmers Dairy PO Box 8118 Halifax, NS B3K 5Y6 Payment Credit Card Visa Mastercard Card Number: Expiration Date: Cardholder Name: * $20/Shirt (includes tax& shipping) *Allow 6-8 weeks for delivery Date: Customer Information Name: Address: City: Province: Postal Code: Phone E-mail: Forms can be submitted by: Internal Use Only Ship Date: Order Completed: * Mail *Fax (902) 835-1583 *E-mail scan & e-mail to [email protected] Size Quantity Unit Price Amount Grand Total S M L XL XXL

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Post on 13-Jun-2015

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Farmers Beep t-shirt order form

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Page 1: Beep t-shirt order form

Beep T-Shirt Order Form

Farmers DairyPO Box 8118Halifax, NSB3K 5Y6

Payment

Credit Card

Visa

Mastercard

Card Number:

Expiration Date:

Cardholder Name:

* $20/Shirt (includes tax& shipping) *Allow 6-8 weeks for delivery

Date:

Customer Information

Name:

Address:

City:

Province:

Postal Code:

Phone

E-mail:

Forms can be submitted by:

Internal Use Only

Ship Date:

Order Completed:

* Mail *Fax(902) 835-1583

*E-mailscan & e-mail to [email protected]

Size Quantity Unit Price Amount

Grand Total

S

M

L

XL

XXL